PDF(Pubmed)
Abstract：
Eosinophilic esophagitis (EoE) is a chronic type 2 inflammation-mediated disease characterized by an eosinophil-predominant inflammation of the esophagus and symptoms of esophageal dysfunction. Relevant treatment outcomes in the setting of EoE include the improvement of histology, symptoms, and endoscopy findings, quality of life (QoL), and the psychological burden of the disease. Established validated tools for the assessment of EoE include questionnaires on dysphagia and QoL (ie, DSQ, EEsAI, and EoE-IQ). More recently, esophageal symptom-specific anxiety and hypervigilance, assessed using the esophageal hypervigilance and anxiety scale (EHAS), have emerged as contributors to disease burden, confirming the importance of psychological aspects in EoE patients. The EoE endoscopic reference score (EREFS) is the only validated endoscopy score in EoE and can quantify mucosal disease burden. However, esophageal panometry using the functional lumen imaging probe (FLIP) and high-resolution manometry (HRM) have shown potential to optimize the assessment of fibrostenotic features of EoE, providing novel insights into the pathophysiology of symptoms. There is a growing number of licenced and off-label therapeutic options in EoE, with various randomized controlled trials demonstrating the efficacy of proton pump inhibitors, topical steroids, food elimination diets, biological drugs, and esophageal dilatation. However, standardized optimal management strategies of EoE are currently lacking. In this review, we provide an overview of established and novel assessment tools in EoE including patient reported outcomes, FLIP panometry, HRM, endoscopy, and histology outcome measures to improve the outcomes of EoE patients. In addition, we summarize available therapeutic options for EoE based on the most recent evidence.
摘要：
嗜酸性粒细胞性食管炎（EoE）是一种慢性2型炎症介导的疾病，其特征是食道嗜酸性粒细胞占优势的炎症和食道功能障碍的症状。EoE的相关治疗结果包括组织学的改善，症状,和内窥镜检查结果，生活质量（QoL），和疾病的心理负担。用于评估EoE的已建立的经过验证的工具包括有关吞咽困难和QoL的问卷（即，DSQ,EEsAI,和EoE-IQ）。最近,食管症状特异性焦虑和过度警觉,使用食管高警惕和焦虑量表(EHAS)进行评估，已经成为疾病负担的贡献者，证实心理方面在EoE患者中的重要性。EoE内镜参考评分（EREFS）是EoE中唯一经过验证的内镜评分，可以量化粘膜疾病负担。然而,使用功能性管腔成像探针（FLIP）和高分辨率测压法（HRM）的食管测通法显示出优化EoE纤维狭窄特征评估的潜力，为症状的病理生理学提供新的见解。EoE中有越来越多的许可和标签外治疗选择，各种随机对照试验证明了质子泵抑制剂的有效性，局部类固醇，消除食物的饮食，生物药物，食道扩张.然而,目前缺乏标准化的EoE优化管理策略。在这次审查中,我们概述了EoE中已建立和新颖的评估工具，包括患者报告的结果，FLIPpanometry,HRM,内窥镜检查,和组织学结局措施，以改善EoE患者的结局。此外,我们根据最新证据总结了EoE的可用治疗方案.
